Lawhead Connor, Silver Jamilah, Olino Thomas M, Labache Loïc, Juhng Swanie, Schwartz H Andrew, Klein Daniel N
Department of Psychology, Stony Brook University, Stony Brook, New York, USA.
Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA.
Clin Psychol Sci. 2025 Aug 16. doi: 10.1177/21677026251357589.
Current classification systems of psychopathology focus on cross-sectional symptomatology rather than continuity, discontinuity and comorbidity across development. Here, a community sample of 600 youth was assessed every 3 years from early childhood through late adolescence using semi-structured diagnostic interviews. We used longitudinal -means clustering of joint-diagnostic trajectories to identify 6 distinct clusters (healthy, childhood anxiety, childhood/adolescent ADHD, adolescent depression/anxiety, adolescent depression/substance use, and early childhood disruptive behavior). When comparing psychopathology clusters to the healthy cluster on age 3 predictors (parental education and psychopathology, early environment, temperament, cognitive and social functioning) and age 18 functional outcomes, the clusters captured developmental patterning of psychopathology not apparent in cross-sectional nosology. The study serves as a proof of principle in applying a longitudinal clustering approach to common mental disorders, affording a rich perspective on the unfolding of sequential comorbidity and heterotypic continuity and identifying transdiagnostic subgroups with meaningful clinical, family, and temperamental correlates.
当前的精神病理学分类系统侧重于横断面症状学，而非整个发育过程中的连续性、不连续性和共病情况。在此，我们通过半结构化诊断访谈，对600名青少年组成的社区样本从幼儿期到青春期后期每3年进行一次评估。我们使用联合诊断轨迹的纵向均值聚类来识别6个不同的类别（健康、儿童期焦虑、儿童期/青少年期注意力缺陷多动障碍、青少年期抑郁/焦虑、青少年期抑郁/物质使用以及幼儿期破坏性行为）。在将精神病理学类别与3岁时的预测因素（父母教育程度和精神病理学、早期环境、气质、认知和社会功能）以及18岁时的功能结局进行比较时，这些类别呈现出横断面疾病分类学中不明显的精神病理学发展模式。该研究证明了将纵向聚类方法应用于常见精神障碍的可行性，为相继出现的共病和异型连续性的发展提供了丰富视角，并识别出具有有意义的临床、家庭和气质相关性的跨诊断亚组。
